Department of Anaesthesiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Med Hypotheses. 2011 May;76(5):733-6. doi: 10.1016/j.mehy.2011.02.010. Epub 2011 Feb 26.
Postoperative cognitive dysfunction (POCD) is reported to occur frequently after all types especially cardiac surgery in elderly patients. It can be short-term or long-term and some cases even develop into Alzheimer's disease (AD). Although multi-risk factors associated with POCD have been identified, the etiology and pathophysiological mechanisms of this surgical complication remain elusive. Therefore, developing strategies for preventing or treating POCD is still challenging. However, increasing evidence suggests that central and systemic inflammation triggered by surgery likely plays a fundamental role in POCD developing and progression. Minocycline, a tetracycline derivative with anti-inflammatory properties, has been shown to be effective in treating neuroinflammatory related conditions or neurodegenerative diseases such as AD, Parkinson's disease, Huntington's disease. Considering that inflammation may be a potential factor of POCD and minocycline is effective in improving cognitive dysfunction induced by inflammation, we hypothesize that minocycline may be useful to treat/prevent the POCD development after surgery in elderly patients.
术后认知功能障碍(POCD)被报道在老年人接受各种类型的手术后,尤其是心脏手术后经常发生。它可以是短期的,也可以是长期的,有些病例甚至发展为阿尔茨海默病(AD)。尽管已经确定了与 POCD 相关的多种风险因素,但这种手术并发症的病因和病理生理机制仍不清楚。因此,开发预防或治疗 POCD 的策略仍然具有挑战性。然而,越来越多的证据表明,手术引起的中枢和全身炎症可能在 POCD 的发展和进展中起着根本性的作用。米诺环素是一种具有抗炎特性的四环素衍生物,已被证明对治疗神经炎症相关疾病或神经退行性疾病如 AD、帕金森病、亨廷顿病有效。鉴于炎症可能是 POCD 的一个潜在因素,米诺环素在改善炎症引起的认知功能障碍方面有效,我们假设米诺环素可能对治疗/预防老年患者手术后 POCD 的发生有用。